HIV/AIDS Risks among Men and Women Who Drink at Informal Alcohol Serving Establishments (Shebeens) in Cape Town, South Africa

Abstract

HIV/AIDS is devastating southern Africa and the spread of HIV is fueled in some populations by alcohol use. Alcohol serving establishments, such as informal drinking places or shebeens, often serve as high-risk venues for HIV transmission. The current study examined the HIV risks of men (N = 91) and women (N = 248) recruited from four shebeens in a racially integrating township in Cape Town South Africa. Participants completed confidential measures of demographic characteristics, HIV risk history, alcohol and drug use, and HIV risk behaviors. Comparisons of 94 (28%) participants who reported meeting sex partners at shebeens to the remaining sample of shebeen goers, controlling for potential confounds, demonstrated a pattern of higher risk for HIV infection among persons who met sex partners at shebeens. Few differences, however, were observed between men (N = 47) and women (N = 47) who had met sex partners at shebeens, suggesting greater gender similarities than gender differences in this important subpopulation. These results indicate an urgent need for multi-level HIV prevention interventions targeting shebeens and the men and women who drink in these settings.

The Relationship Between Alcohol Consumption and Human Immunodeficiency Virus Infection and Risk Behaviour: A Systematic Literature Review of High-Risk Groups, with a Focus on South Africa

“…A South African study by Townsend et al (2010) attempted to answer the question: ''Are condoms applied less effectively and consistently by men who drink heavily compared to those who do not?'' The study replicated findings from other studies, (Kalichman et al, 2008;Simbayi et al 2006) that heavy drinkers, if they use condoms, use them inconsistently.…”

Density of Drinking Establishments and HIV Prevalence in a Migrant Town in Namibia

“…A significant association between having met sex partners at a shebeen and unprotected vaginal sex versus those who did not meet partners at shebeens has been previously observed demonstrated [8]. Problem drinking was associated with having two or more sex partners in the last three months compared to those not having problem drinking [7].…”

“…In a study that compared patterns of problem alcohol use with regard to risk of testing HIV positive or having HIV risk factors, problem drinking was associated with having two or more sex partners in the last three months as compared to not having problem drinking (OR=3.0, 95% CI 1.9-4.4) [7]. Other research has suggested an association between having met sex partners at shebeens and unprotected vaginal sex (OR=1.1, 95% CI 1.1-1.2), as compared to those who did not meet partners at shebeens [8].…”

“…The relation between alcohol consumption and exposures related to HIV, such as unprotected sex has been evaluated [7,8]. In a study that compared patterns of problem alcohol use with regard to risk of testing HIV positive or having HIV risk factors, problem drinking was associated with having two or more sex partners in the last three months as compared to not having problem drinking (OR=3.0, 95% CI 1.9-4.4) [7].…”

Commentary on Halonen et al. (2013): Exposure to alcohol outlets and alcohol consumption‐back to square one?

“…shebeens). Kalichman and colleagues propose that it is not alcohol use that poses the risk, but the expectancies of high-risk individuals who frequent the alcohol outlets [6,7]. Similarly, the numerous studies observing associations between exposure to alcohol outlets and various types of violence typically propose a variety of mechanisms that avoid a central role for alcohol consumption [8][9][10][11][12].…”